Attenuation <scp>corrected‐optical</scp> coherence tomography for quantitative assessment of skin wound healing and scar morphology

Ghosh, Biswajoy; Mandal, Mousumi; Mitra, Pabitra; Chatterjee, Jyotirmoy

doi:10.1002/jbio.202000357

Cited by 23 publications

(17 citation statements)

References 82 publications

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“…The reduction in OAC values observed both qualitatively and quantitatively in imaging session #2 (Figs. 5 and 6, respectively) is thought to be caused by the newly generated tissue whose optical properties differ from those of normal tissue before injury [38,39]. In all, the OAC mapping derived from our OCT data has the potential to both aid in our understanding of the pathological changes known to occur in human skin following acute burn injury, and serve as an indicator of tissue injury.…”

Section: Discussionmentioning

confidence: 93%

“…First, we did not acquire histological data to validate the parameters (i.e., epidermal thickness and OAC) discussed above. This is largely because such correlations have previously been shown between OCT-derived and histologically-derived epidermal thickness measurements [20], and OCT-derived and histologically-derived OAC [38]. Second, a number of optical properties known to occur in skin tissue, such as birefringence, phase retardation, and degree of polarization, were not accounted for in this study.…”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, in addition to OAC being used to improve imaging contrast, it can also serve as a physical parameter for evaluating tissue characteristics [36] because changes in tissue morphology and content can alter a tissue's OAC. Previous works have shown promising results in the application of OAC to monitoring skin wound healing [37,38], assessing burn scars [39,40], identifying brain cancer [41], and evaluating brain damage [42]. Although each study above was successful in clarifying exciting findings regarding changes of tissue properties, each was not without its particular disadvantages.…”

Section: Introductionmentioning

confidence: 99%

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Application of OCT‐Derived Attenuation Coefficient in Acute Burn‐Damaged Skin

Deegan

Cheng

et al. 2021

Lasers Surg Med

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Background and Objectives: There remains a need to objectively monitor burn wound healing within a clinical setting, and optical coherence tomography (OCT) is proving itself one of the ideal modalities for just such a use. The aim of this study is to utilize the noninvasive and multipurpose capabilities of OCT, along with its cellularlevel resolution, to demonstrate the application of optical attenuation coefficient (OAC), as derived from OCT data, to facilitate the automatic digital segmentation of the epidermis from scan images and to work as an objective indicator for burn wound healing assessment. Study Design/Materials and Methods: A simple, yet efficient, method was used to estimate OAC from OCT images taken over multiple time points following acute burn injury. This method enhanced dermal-epidermal junction (DEJ) contrast, which facilitated the automatic segmentation of the epidermis for subsequent thickness measurements. In addition, we also measured and compared the average OAC of the dermis within said burns for correlative purposes. Results: Compared with unaltered OCT maps, enhanced DEJ contrast was shown in OAC maps, both from single A-lines and completed B-frames. En face epidermal thickness and dermal OAC maps both demonstrated significant changes between imaging sessions following burn injury, such as a loss of epidermal texture and decreased OAC. Quantitative analysis also showed that OAC of acute burned skin decreased below that of healthy skin following injury. Conclusions: Our study has demonstrated that the OAC estimated from OCT data can be used to enhance imaging contrast to facilitate the automatic segmentation of the epidermal layer, as well as help elucidate our understanding of the pathological changes that occur in human skin when exposed to acute burn injury, which could serve as an objective indicator of skin injury and healing.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Application of OCT‐Derived Attenuation Coefficient in Acute Burn‐Damaged Skin

Deegan

Cheng

et al. 2021

Lasers Surg Med

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“…Other metrics have been applied, 35 and objective evaluation of wound healing using for example histological examination and optical coherence tomography would have provided more in-depth results. 36 The wound-healing stimulating effect was more marked at postoperative week 3 than at week 4. This indicates that additional application might further improve the beneficial effect of L-PRP.…”

Section: L-prp Characterization In Healthy Volunteersmentioning

confidence: 93%

The wound healing effect of local leukocyte platelet‐rich plasma after total hip arthroplasty: A randomized controlled trial

Capion

Jørgensen

Ågren

et al. 2021

Wound Repair Regeneration

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Rapid wound closure is important after arthroplasty procedures to prevent postoperative complications. Platelets are rich in growth factors and leukocytes contribute to innate immunity. We hypothesized that topical leukocyte platelet-rich plasma (L-PRP) derived from the blood of patients would be beneficial to wound healing. In this randomized controlled trial, patients subjected to elective total hip arthroplasty (THA) were assigned by concealed allocation either L-PRP application onto the sutured fascia or no application (control) after the THA intervention. In addition, all patients received 1.5 g protein/kg, 5 g L-arginine, 500 mg vitamin C and 44 mg zinc daily over the 4-week postoperative period to obtain optimal nutrition. The primary endpoint was complete healing of the skin incision. The secondary endpoints were blood transfusions, length of hospital stay, pain and wound infections. Sixteen patients in the L-PRP group and 17 patients in the control group completed the trial. L-PRP treatment accelerated complete wound healing after 3 weeks (seven in the L-PRP group vs. zero in the control group, p = 0.003) and after 4 weeks (12 in the L-PRP group vs. six in the control group, p = 0.037). No postoperative superficial wound infections occurred within 4 weeks, and there were no significant differences in the other secondary outcomes. L-PRP generated in 10 sex-matched healthy volunteers revealed increased concentrations of platelets (5.8-fold) and leukocytes (2.3-fold) compared with those in whole blood. Furthermore, the concentration of keratinocyte mitogen epidermal growth factor in L-PRP (380 ± 130 pg/ml, mean ± SD) was higher (p < 0.001) than that in serum (130 ± 26 pg/ml). In conclusion, a single intraoperative local application of L-PRP promoted wound healing after THA, possibly mediated by EGF receptor agonists.

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“…In addition to characterizing structural changes, OCT augmented with special features such as spectral analysis (22) and Doppler shift algorithms (21) could also provide functional images depicting hemoglobin concentration and blood flow information, respectively. However, OCT probes and setups are sensitive optical imaging systems with limited field of view and often suffer from attenuation loss, revealing speckles and bright artifacts due to multiple scattering of light (23,24). Further, OCT systems are commonly bulky and expensive and are not commensurate with the restrictive infrastructure inevitable in resource-limited settings.…”

mentioning

confidence: 99%

Portable, handheld, and affordable blood perfusion imager for screening of subsurface cancer in resource-limited settings

Bhowmik

Ghosh

Pal³

et al. 2022

Proc. Natl. Acad. Sci. U.S.A.

Self Cite

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Precise information on localized variations in blood circulation holds the key for noninvasive diagnostics and therapeutic assessment of various forms of cancer. While thermal imaging by itself may provide significant insights on the combined implications of the relevant physiological parameters, viz. local blood perfusion and metabolic balance due to active tumors as well as the ambient conditions, knowledge of the tissue surface temperature alone may be somewhat inadequate in distinguishing between some ambiguous manifestations of precancer and cancerous lesions, resulting in compromise of the selectivity in detection. This, along with the lack of availability of a user-friendly and inexpensive portable device for thermal-image acquisition, blood perfusion mapping, and data integration acts as a deterrent against the emergence of an inexpensive, contact-free, and accurate in situ screening and diagnostic approach for cancer detection and management. Circumventing these constraints, here we report a portable noninvasive blood perfusion imager augmented with machine learning–based quantitative analytics for screening precancerous and cancerous traits in oral lesions, by probing the localized alterations in microcirculation. With a proven overall sensitivity >96.66% and specificity of 100% as compared to gold-standard biopsy-based tests, the method successfully classified oral cancer and precancer in a resource-limited clinical setting in a double-blinded patient trial and exhibited favorable predictive capabilities considering other complementary modes of medical image analysis as well. The method holds further potential to achieve contrast-free, accurate, and low-cost diagnosis of abnormal microvascular physiology and other clinically vulnerable conditions, when interpreted along with complementary clinically evidenced decision-making perspectives.

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Attenuation corrected‐optical coherence tomography for quantitative assessment of skin wound healing and scar morphology

Cited by 23 publications

References 82 publications

Application of OCT‐Derived Attenuation Coefficient in Acute Burn‐Damaged Skin

Application of OCT‐Derived Attenuation Coefficient in Acute Burn‐Damaged Skin

The wound healing effect of local leukocyte platelet‐rich plasma after total hip arthroplasty: A randomized controlled trial

Portable, handheld, and affordable blood perfusion imager for screening of subsurface cancer in resource-limited settings

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